Comparision of Low Birth Weight Babies in Mothers Seeking Antenatal Care Services at a Tertiary Care Hospital and at Other Healthcare Facilities: A Cross-sectional Study

Introduction: The high prevalence of Low Birth Weight (LBW) due to Preterm Birth (PTB) and Intrauterine Growth Restriction (IGUR) still persist a challenge in India. This happens due to poor and infrequent utilisation of Antenatal Care (ANC) service. Aim: To assess the difference of PTB and LBW in mothers, who availed ANC at a tertiary care hospital against those who availed ANC at other healthcare facility. Materials and Methods: This cross-sectional study was conducted at Gynaecology Department in Sir Sundarlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India. The data was obtained from the delivery register maintained at the Labour Room of the Department. The age of the mother, place where ANC services availed, birth weight of the newborn and the gestational age were recorded on a master chart. The newborn were considered LBW, if birth weight was <2500 gm, PTB if birth occurred <37 completed weeks of gestation and Intrauterine Growth Restriction (IUGR), if birth weight was below the expected weight at birth for the gestational age. The prevalence of PTB, LBW and mean with SD of LBW were obtained. The association of PTB and LBW with place of ANC services availed was judged using Chi-square test. The 95% confidence interval of the prevalence was obtained by using logit transformation. Results: Out of total 2420 deliveries, 1858 mothers and their newborn were analysed. The mean age of mothers was 26.4 +/- 4.3 years. Half (50.1%) of the mothers had taken ANC at SS Hospital and the rest at other healthcare facilities. The prevalence of LBW and PTB babies were 29.2% (95% CI: 27.1-31.3) and 28.8% (95% CI: 26.7-30.9), respectively. Overall, both PTB and LBW were found to be significantly associated with the place of ANC services. Prevalence of LBW born in mothers who received ANC at tertiary care hospital was 19.4%; while it was 39.0% in those receiving at other healthcare facilities. The prevalence of PTB and LBW was more than 1.6 times and twice in those taken ANC at other health care facilities than those at TCH irrespective of gestational age. Among the PTB, the LBW were 42.2% in mothers receiving ANC at the Tertiary Care Center (TCH) against 65.6% in those receiving at other healthcare facilities. Among the full-term deliveries also, the LBW born were 13.1% in mothers receiving ANC at tertiary care as against 24.3% in those receiving at other healthcare facilities. Conclusion: The mothers seeking ANC services at other healthcare facilities need education about the advantage of ANC by the service providers, for timely and better adherence to ANC.